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系统性红斑狼疮患者的妊娠问题。

Pregnancy in systemic lupus erythematosus.

机构信息

Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa, Italy; Department of Medical Biotechnologies, University of Siena, Italy.

Medical Faculty, Department Rheumatology & Hiller-Research Unit Rheumatology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.

出版信息

Best Pract Res Clin Rheumatol. 2023 Dec;37(4):101860. doi: 10.1016/j.berh.2023.101860. Epub 2023 Aug 16.

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which frequently affects women of childbearing age. Nowadays, pregnancy is not contraindicated in cases of well-controlled disease activity, but pregnancies are still at higher risk of maternal and fetal complications compared to the general population. During pregnancy and puerperium patients are at risk of disease flare, and obstetric complications are more frequent in cases of active disease at conception/beginning of pregnancy, a history of lupus nephritis, and concomitant presence of antiphospholipid syndrome. To improve pregnancy outcomes in SLE patients, appropriate preconception counseling with changes in medication, if necessary, and close rheumatological and obstetrical monitoring are fundamental. This review aims to summarize the risk factors for adverse pregnancy outcomes and provide an update on developments in medical care for pregnancy in SLE patients.

摘要

系统性红斑狼疮(SLE)是一种慢性自身免疫性疾病,常发生于育龄期女性。目前,对于病情控制良好的患者,妊娠并非禁忌,但与普通人群相比,SLE 患者妊娠仍具有较高的母婴并发症风险。在妊娠和产褥期,患者有疾病活动的风险,而在疾病活动时受孕/妊娠早期、有狼疮肾炎病史以及同时存在抗磷脂综合征的情况下,产科并发症更为常见。为改善 SLE 患者的妊娠结局,基本的方法是进行适当的孕前咨询,必要时调整药物,并密切进行风湿科和产科监测。本综述旨在总结不良妊娠结局的危险因素,并提供 SLE 患者妊娠相关医疗护理的最新进展。

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